Jade (HMO) with Bene-Flex™

Part D Prescription Drug Coverage
Jade features Part D Prescription Drug Coverage, including $0 copays for Tier 1 preferred generic drugs, Tier 6 Select Care drugs, including vaccines and common over-the-counter (OTC) drugs.

Dental Coverage
Through our partnership with Delta Dental of Ohio, you're covered for two cleanings and exams, one X-ray and fluoride treatment at $0.You are also covered for bridges, crowns, crown repairs and dentures at 20% coinsurance. The annual maximum for preventive and comprehensive dental services is $3,000.

Vision Coverage
You’ll receive an annual reimbursement to use toward the purchase of frames/lenses or contact lenses with the freedom to purchase anywhere you choose. Coverage also includes diagnostic and routine vision exams for a $0 copay.

Hearing Aid Coverage
You’re covered for one hearing aid per ear every year from our formulary, after paying $395 per hearing aid for Level 1 hearing aids and $695 per hearing aid for Level 2 hearing aids. Amplifon does have additional hearing-aid models available for purchase at a discounted rate. And, all routine hearing exams are covered for a $0 copay.

Travel Coverage

If you travel to the states of Arizona, Florida, Texas or NEW for 2025 North Carolina and South Carolina, you’ll receive in-network coverage for medical benefits received by any Medicare-approved provider.

Our plans have built-in worldwide emergency, urgent care coverage and ambulance services too, so you can travel close to home, or around the world, worry-free.

Acupuncture
You're covered for up to 10 general acupuncture visits.

Chiropractic Care
Up to 10 office visits and all manipulations from in-network chiropractors are included in Jade plan coverage.

Fitness Tracker
One Fitbit® fitness tracker per calendar year. These wearable health and wellness devices encourage physical activity through accountability and achievements for better health outcomes. Each Fitbit must be ordered through SummaCare’s vendor, Tivity Health.

Toenail Trimming
Up to four visits per calendar year. Trimming performed by in-network podiatrists.

Nutrition Coaching
Up to four visits per calendar year. Services provided by a SummaCare registered dietitian or via Teladoc.

BrainHQ Memory Fitness
SummaCare is excited to offer BrainHQ — your online headquarters for working out your brain.

Think of it as a personal gym, where you exercise your memory, attention, brain speed, people skills, intelligence and navigation instead of your abs, delts and quads. Just as our bodies require care and exercise over the course of life, so do our brains—especially as we age. BrainHQ provides the exercise your brain needs to be at its sharpest.

Massage Therapy
You're covered for up to 10 therapeutic massage therapy visits. Requires a provider's order.

SilverSneakers®
The SilverSneakers fitness program is the nation’s leading wellness program for Medicare beneficiaries. You’ll receive a fitness membership at no cost to you with access to basic amenities, group exercise classes and online resources at participating fitness locations.

Transportation
You're covered for up to 24 one-way trips to medical appointments. Most trips can be scheduled in as little as 30 minutes and you can see providers throughout SummaCare’s 33-county service area. HOMELINK coordinates most transportation trips using local ride-share vendors such as Uber and Lyft.

Indoor Air Quality*
One air purifier per calendar year. The purifier must be obtained through HOMELINK or members will be responsible for the full cost of the unit.

* This benefit is part of a special supplemental program for the chronically ill; members must have a diagnosis of asthma and/or COPD — including chronic bronchitis and/or emphysema to choose/utilize it.

Post-Discharge or Chronic Care** Meal Delivery
Healthy, fully-prepared, nutritious meals created by chefs and registered dieticians and delivered directly to your home. Choose either 28 meals post-discharge or 84 meals for chronic care.

** This benefit is part of a special supplemental program for the chronically ill; members must have a diagnosis of diabetes mellitus type 1 or type 2, congestive heart failure, chronic kidney disease, COPD, coronary artery disease, chronic non-alcoholic fatty liver disease, autoimmune disease, chronic and disabling mental health conditions, or neurologic disorders to choose/utilize it.

Papa Pals
Hang Out and Help Out. Papa pairs older adults and families with Papa Pals for companionship and assistance with everyday tasks. Get help around the house, including light housework, a ride to the doctor’s office, pharmacy (or anywhere around town), help with errands or simply someone to talk to. Providing support to SummaCare Medicare Advantage members also offers relief and respite to caregivers. You receive up to 40 hours of assistance per calendar year provided through Papa Pals.

Flex Card for Vision, Dental & Hearing
Up to $500 Benefit Bucks on your SummaCare Visa card to be used to pay dental, hearing or vision providers directly for any out-of-pocket expenses you may incur. The card is not a credit card. The debit card may not be redeemed for cash or used to pay for another individual’s expenses. Unused balances will not roll over to the next calendar year. If a provider does not accept debit card payments or if there is a card transaction failure, members may submit a claim form for reimbursement along with the original printed, itemized provider receipt.

Healthy Grocery Allowance**
$40 allowance per month. Benefit may be used to purchase healthy grocery items—an essential step in managing chronic medical conditions and helping maintain or improve your overall health. Unused grocery benefit balances will not roll over to the next month or calendar year. Make purchases using your SummaCare Visa card at any participating retailers nationwide.

** This benefit is part of a special supplemental program for the chronically ill; members must have a diagnosis of diabetes mellitus type 1 or type 2, congestive heart failure, chronic kidney disease, COPD, coronary artery disease, chronic non-alcoholic fatty liver disease, autoimmune disease, chronic and disabling mental health conditions, or neurologic disorders to choose/utilize it.

PERS (personal Emergency Response System)
The PERS (Personal Emergency Response System), offered through ConnectAmerica, provides 24/7 emergency assistance and care — and is GPS-enabled to work outside the home.

Home Safety Devices
$400 for home safety devices, such as grab bars, shower stools and more.